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  • Accessing Targeted Therapies: A Potential Roadblock to Implementing Precision Oncology?

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    Von Itzstein485564-Published.pdf (357.6Kb)
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    Version of Record (VoR)
    Author(s)
    von Itzstein, Mitchell S
    Smith, Mary L
    Railey, Elda
    White, Carol B
    Dieterich, Julianne S
    Garrett-Mayer, Liz
    Bruinooge, Suanna S
    Freedman, Andrew N
    De Moor, Janet
    Gray, Stacy W
    Park, Jason Y
    Yan, Jingsheng
    Hoang, Anh Quynh
    Zhu, Hong
    Gerber, David E
    Griffith University Author(s)
    Von Itzstein, Mitchell S.
    Year published
    2021
    Metadata
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    Abstract
    PURPOSE: Advances in genomic techniques have led to increased use of next-generation sequencing (NGS). We evaluated the extent to which these tests guide treatment decisions. METHODS: We developed and distributed a survey assessing NGS use and outcomes to a survey pool of ASCO members. Comparisons between groups were performed with Wilcoxon two-sample, chi-square, and Fisher's exact tests. RESULTS: Among 178 respondents, 62% were male, 54% White, and 67% affiliated with academic centers. More than half (56%) indicated that NGS provided actionable information to a moderate or great extent. Use was highest (median ≥ 70% of ...
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    PURPOSE: Advances in genomic techniques have led to increased use of next-generation sequencing (NGS). We evaluated the extent to which these tests guide treatment decisions. METHODS: We developed and distributed a survey assessing NGS use and outcomes to a survey pool of ASCO members. Comparisons between groups were performed with Wilcoxon two-sample, chi-square, and Fisher's exact tests. RESULTS: Among 178 respondents, 62% were male, 54% White, and 67% affiliated with academic centers. More than half (56%) indicated that NGS provided actionable information to a moderate or great extent. Use was highest (median ≥ 70% of cases) for lung and gastric cancer, and lowest (median < 25% of cases) in head and neck and genitourinary cancers. Approximately one third of respondents reported that, despite identification of an actionable molecular variant, patients were sometimes or often unable to access the relevant US Food and Drug Administration-approved therapy. When NGS did not provide actionable results, individuals reporting great or moderate guidance overall from NGS in treatment recommendations were more likely to request the compassionate use of an unapproved drug (P < .001), enroll on a clinical trial (P < .01), or treat off-label with a drug approved for another indication (P = .02). CONCLUSION: When NGS identifies an actionable result, a substantial proportion of clinicians reported encountering challenges obtaining approved therapies on the basis of these results. Perceived overall impact of NGS appears associated with clinical behavior unrelated to actionable NGS test results, including pursuing off-label or compassionate use of unapproved therapies or referring to a clinical trial.
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    Journal Title
    JCO Oncology Practice
    DOI
    https://doi.org/10.1200/OP.20.00927
    Copyright Statement
    © 2021 American Society of Clinical Oncology. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
    Note
    This publication has been entered in Griffith Research Online as an advanced online version.
    Subject
    Oncology and carcinogenesis
    Publication URI
    http://hdl.handle.net/10072/404649
    Collection
    • Journal articles

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